CLIA Certification Number - Missing/Invalid - JF Part B

Common Reasons for Message

• CLIA certification number billed in Item 23 of CMS-1500 Claim Form (or electronic equivalent) was either missing or invalid
• Incorrect qualifier was used on electronic claim

Next Step

• Resubmit claim with valid CLIA certification number in Item 23 of CMS-1500 Claim Form
  • CLIA numbers are 10 digits with letter "D" in third position
• Resubmit with valid qualifier or CLIA certificate number on Electronic Claim
  • Qualifier to indicate CLIA certification number must be submitted as X4
  • Review EDI training document on billing laboratory claims electronically

Claim Submission Tips

• Apply for CLIA Certification prior to rendering lab services
• Review codes that require a CLIA certification number
• Qualifier is only required on electronic claims